Unsafe sleeping conditions for infants prompt DCS to give away cribs

Agency to make sure proper beds provided to clients

Sep. 13, 2013

In nearly 80 percent of infant sleep deaths, the baby was put to sleep somewhere other than a crib or bassinet. DCS and other agencies are teaming up to make sure that no DCS caseworker leaves a baby in a home without a crib. / John Partipilo / The Tennessean

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The Tennessean

Among the children whose deaths were investigated by the Department of Children’s Services between 2009 and mid-2012, there were at least three dozen infants who died in their sleep.

In many cases, they were put to bed somewhere other than a crib or bassinet.

One 11-month-old Bradley County boy suffocated after falling face forward from a baby pillow on which his foster parents had placed him to sleep. A 2-month-old Wayne County boy was found dead after his father fell asleep with him on the family sofa. A 10-month-old Hamilton County girl born with Down syndrome was found dead after being left to nap in a baby swing, covered in a blanket.

In fact, in 82 percent of all infant sleep deaths in Tennessee — not just those occurring among families already under scrutiny by DCS — the baby was put to sleep on a sofa, a bed, a bouncy chair, a drawer, a waterbed, a floor, or somewhere other than a crib or bassinet, according to the Tennessee Department of Health.

The large number of unsafe sleeping deaths has prompted DCS to collaborate with other agencies in East Tennessee to launch a pilot crib giveaway project.

“Hospitals don’t allow parents to leave without a car seat,” said DCS Commissioner Jim Henry. “We’re not going to leave a home until a kid has a crib.” Henry said the agency hopes to expand the effort statewide.

The East Tennessee Safe Sleep Initiative, as the pilot is called, has given away 50 cribs since May to new Knox County parents.

Some of the families on the receiving end of the cribs had no plans to buy one, relying on cultural or family traditions to place their babies to sleep in beds or other places.

But Knox County DCS workers and health officials noticed that there were families unable to afford a crib, a problem made worse in recent years by the economy as well as new federal crib safety guidelines issued in 2010.

Cribs safer, costlier

The guidelines made cribs safer but more expensive and made it illegal to sell cribs second-hand, said Alicia Mastronardi, an epidemiologist with the Knox County Health Department. The department is collaborating with DCS and other local agencies to deliver cribs to families that do not have one.

For years, health officials around the state have been working to combat Tennessee’s grim rankings for infant mortality. Last year, even after a slight decline in infant deaths, Tennessee still ranked fifth in the nation in the number of infants dying before their first birthday.

Officials note the causes go beyond how a baby is put to sleep. Deaths occur for a range of reasons, from lack of prenatal care and babies born with low birth weights to child abuse and neglect to congenital disease. But what the vast majority of deaths during sleep have in common is where the baby was put to sleep, said Dr. Michael Warren, director of maternal and child health for the Department of Health.

“If we were somehow able to eliminate all those sleep-related deaths, our infant mortality rates would move us from bottom 10 to the national average,” said Dr. Michael Warren. “It would catapult us by simply focusing on that one risk factor.”

The Department of Health has begun a similar pilot project to give away 250 cribs. The agency also has an ongoing education campaign about how best to put a baby to sleep, spreading the message of the ABCs: The campaign emphasized that babies should be put to sleep alone, without any covers or toys, on their backs and in a crib.